Navarro Edgar, Mijac Volga, Ryder Hermes Flórez y Elena
Clínica Industrial Anaco, Anaco.
Arch Latinoam Nutr. 2010 Jun;60(2):160-7.
Abdominal obesity and specifically intrabdominal adiposity leads to increase in cardiometabolic risk factors (CMR), independently of body mass index (BMI). In order to examine CMR factors associated with the presence of visceral fat (VF) in individuals with different degrees of overweight/obesity, 154 men, 20 to 60 years of age, attending a at an Industrial Clinic in Venezuela, were evaluated. Ultrasound was used to establish the presence and amount of VF. As expected, VF values were higher as the BMI increased. It was observed that VF was associated positive and significantly with age, abdominal circumference and the degree of insulin resistance (HOMA-IR) in subjects with normal weight as well as in those with overweight and obesity. However, BMI was correlated with VF only in those with normal weight or overweight. In the obese a positive correlation was observed between VF with glycemia and triglycerides, while insulin was correlated with VF only in the subjects with normal weight. Based on the ROC curves, and taking as cut-off point for VF a value of 6 cm, it was possible to predict the presence of hyperglycemia with a 58.6% of sensitivity and 77% of specificity, presence of insulin resistance with 54 % of sensitivity and 78 % specificity, hypertriglyceridemia with 39% of sensitivity and 78% specificity and low HDLc with 45% sensitivity and 77% specificity. The area under the curve for the ROC analysis was greater for visceral fat compared with abdominal circumference for hyperglicemia (0.727 vs. 0.693, p < 0.05) and hypertrigliceridemia (0.678 vs. 0.621, p < 0.05) while the opposite was observed for HOMA-IR (0.74 vs. 0.788, p < 0.05) and for low HDL-c (0.651 vs. 0.668, p < 0.05). We conclude that ultrasound measure of VF, was better in predicting hyperglycemia and hypertriglyceridemia, while abdominal circumference was better predicting insulin resistance and low HDLc and could be useful in the preventive evaluation of individuals at risk for diabetes or cardiovascular disease.
腹部肥胖,尤其是腹内脂肪增多,会导致心脏代谢风险因素(CMR)增加,且独立于体重指数(BMI)。为了研究不同超重/肥胖程度个体中与内脏脂肪(VF)存在相关的CMR因素,对委内瑞拉一家工业诊所的154名年龄在20至60岁的男性进行了评估。使用超声来确定VF的存在和数量。正如预期的那样,随着BMI的增加,VF值升高。研究发现,在体重正常以及超重和肥胖的受试者中,VF与年龄、腹围和胰岛素抵抗程度(HOMA-IR)呈正相关且具有显著相关性。然而,BMI仅在体重正常或超重的人群中与VF相关。在肥胖人群中,VF与血糖和甘油三酯呈正相关,而胰岛素仅在体重正常的受试者中与VF相关。基于ROC曲线,并将VF值6 cm作为截断点,可以预测高血糖的存在,灵敏度为58.6%,特异性为77%;预测胰岛素抵抗的存在,灵敏度为54%,特异性为78%;预测高甘油三酯血症,灵敏度为39%,特异性为78%;预测低HDLc,灵敏度为45%,特异性为77%。对于高血糖(0.727对0.693,p < 0.05)和高甘油三酯血症(0.678对0.621,p < 0.05),ROC分析曲线下面积在内脏脂肪方面大于腹围,而对于HOMA-IR(0.74对0.788,p < 0.05)和低HDL-c(0.651对0.668,p < 0.05)则观察到相反情况。我们得出结论,超声测量VF在预测高血糖和高甘油三酯血症方面更好,而腹围在预测胰岛素抵抗和低HDLc方面更好,并且可用于对糖尿病或心血管疾病风险个体的预防性评估。